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Electronic Medical Records Proved Their Worth in Katrina's Wake

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THURSDAY, April 26 (HealthDay News) -- As the skies darkened over New Orleans the day before Hurricane Katrina unleashed her fury in August 2005, Scharmaine Lawson, a nurse practitioner, grabbed a T-shirt, some underwear, a toothbrush and her Palm Pilot, and headed out of town.

Unbeknownst to Lawson at the time, that small hand-held device, grabbed almost as an afterthought, would end up spelling the difference between life and death for some victims of this country's most devastating natural disaster.

In it, Lawson had stored basic medical records for all of her 100 homebound, elderly patients, most of them also indigent and disabled and living in New Orleans and surrounding parishes.

Electronic medical records refer to a patient's medical records when they're stored on a computer and accessible from different locations. Health practitioners and medical institutions around the United States are starting to adopt them, but they're still far from commonplace.

An estimated 25 percent of office-based doctors in the United States reported using fully or partially electronic medical record systems in 2005, the most recent statistics available. That represented a 31 percent increase from the 18.2 percent reported in a 2001 survey, according to the National Center for Health Statistics.

But electronic records certainly weren't the norm in New Orleans prior to Katrina.

Lawson's physical office in New Orleans was destroyed under 5 feet of water. "We lost everything. Papers were stuck together and full of mud. Nothing could be retrieved," she said.

Lawson at least had her Palm Pilot. Others weren't so lucky. Doctors' offices and hospitals around the city experienced the same waterlogged nightmare, losing patient records permanently.

As Dr. Jay Brooks, chief of hematology/oncology at Ochsner Health System in Baton Rouge, La., pointed out, paper medical records are heavy, and most are stored in a basement or ground floor of a building. "All the records were easily sitting in foul-smelling water for three weeks," he said. "They're all lost."

Brooks remembers seeing refugees from New Orleans who did not know what type of cancer they had or what kind of treatment they had received.

Ochsner started developing an electronic records system 15 years ago and, as a result, information for all 300,000 of its patients was accessible after the storm.

When one Ochsner patient from New Orleans came into Brooks' office after Katrina, he was able to pull up all her records. "She'd had a heart transplant five years earlier and had been diagnosed with breast cancer. She sat in my office. I pulled up all of her records, and when the electronic record came up, it had her home address," Brooks recalled. "She broke down and cried, because her home had been washed away."

Lawson realized quickly that with her Palm Pilot she was "sitting on a gold mine, when a lot of my colleagues had no back-up."

For three months right after Katrina, Lawson operated from a temporary base in San Antonio, Texas, using her handheld to provide vital medical information to doctors and other health-care providers around the nation who were caring for her scattered clientele.

"I was able to communicate with other providers from all over the U.S. I had people calling me from Hawaii, Idaho, Kentucky, saying we have one of your patients here," Lawson said. "I was able to get the documents from my Palm Pilot, download them, print the entire H&P (history and physical), all of their lab work, anything they wanted."

She also served as a missing persons locator.

"One family called me for three weeks straight, desperately looking for a relative, a hospice patient," Lawson recounted. "During the fourth week, a hospice agency in Indiana called to say they had the patient and did I have any of his recent records."

Lawson did. She downloaded the records and faxed them, then called the family.

"They thought he was dead until the hospice agency called," Lawson said.

Since then, Lawson has adopted a formal electronic medical records system, MediNotes, and her practice has quadrupled to more than 400 patients.

Instead of the trusty Palm Pilot, on home visits she takes a tablet with detachable keyboard with her to download patients' information and to provide reminders about flu shots and other needed services.

"She brings the computer thing in here and puts all the information on it," said Brenda Carter, 65, a client who was trapped for two days on her roof in the lower Ninth Ward during Katrina. "I think that's better than paper."

More information

Visit the U.S. National Library of Medicine for more on personal medical records.

SOURCES: Scharmaine Lawson, nurse practitioner, and CEO, Advanced Clinical Consultants, New Orleans; Jay Brooks, M.D., chairman of hematology/oncology, Ochsner Health Service, Baton Rouge, La.; Brenda D. Carter, Harvey, La.
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